Are you Rodolfo Rodríguez-Carrillo?

Claim your profile

Publications (4)3.48 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Perioperative management is one of the fields of surgery most hide bound by tradition and conventional attitudes are difficult to modify even in the face of strong scientific evidence. One of the advances that has most helped to improve the results of colorectal surgery is multimodal or fast-track rehabilitation, which aims to enhance recovery, reduce morbidity, and shorten the length of hospital stay. This modality is based on a multidisciplinary approach provided by surgeons, anesthesiologists and other staff and aims to decrease the response to physiopathological changes induced by surgical aggression. There is evidence to support the use of preoperative oral carbohydrate therapy and oral bowel preparation, the avoidance of intraoperative fluid excess, and the maintenance of normothermia on postoperative recovery. Other factors that can also reduce complications are epidural analgesia, avoidance of drainage and nasogastric decompression, early oral feeding, and minimally invasive surgery. There is strong evidence that the combined use of these and other measures enhances postsurgical recovery, although many of these measures are currently little used in daily practice.
    Cirugía Española 07/2007; 81(6):307-15. · 0.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Mechanical bowel preparation is a traditional procedure for preparing patients for colorectal surgery. This practice aims to reduce the risk of postoperative infectious complications since colonic fecal content has classically been related to stool spillage during surgery and anastomotic disruption. However, increasing evidence against its routine use can be found in experimental studies, clinical observations, prospective studies, and meta-analyses. We performed a review of the literature on mechanical bowel preparation and its consequences. There is no clear evidence that preoperative bowel cleansing reduces the septic complications of surgery and routine use of this procedure may increase anastomotic leaks and morbidity. Therefore, the results suggest that mechanical preparation is not required in elective colon and rectal surgery and that its use should be restricted to specific indications such as small nonpalpable tumors to aid their localization during laparoscopic procedures or to enable intraoperative colonoscopy. The role of mechanical bowel preparation in rectal surgery is not well defined and further trials with a larger number of patients are required.
    Cirugía Española 06/2007; 81(5):240-6. · 0.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Perioperative management is one of the fields of surgery most hidebound by tradition and conventional attitudes are difficult to modify even in the face of strong scientific evidence. One of the advances that has most helped to improve the results of colorectal surgery is multimodal or fast-track rehabilitation, which aims to enhance recovery, reduce morbidity, and shorten the length of hospital stay. This modality is based on a multidisciplinary approach provided by surgeons, anesthesiologists and other staff and aims to decrease the response to physiopathological changes induced by surgical aggression. There is evidence to support the use of preoperative oral carbohydrate therapy and oral bowel preparation, the avoidance of intraoperative fluid excess, and the maintenance of normothermia on postoperative recovery. Other factors that can also reduce complications are epidural analgesia, avoidance of drainage and nasogastric decompression, early oral feeding, and minimally invasive surgery. There is strong evidence that the combined use of these and other measures enhances postsurgical recovery, although many of these measures are currently little used in daily practice.
    Cirugía Española 06/2007; 81(6):307-315. · 0.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Mechanical bowel preparation is a traditional procedure for preparing patients for colorectal surgery. This practice aims to reduce the risk of postoperative infectious complications since colonic fecal content has classically been related to stool spillage during surgery and anastomotic disruption. However, increasing evidence against its routine use can be found in experimental studies, clinical observations, prospective studies, and meta-analyses. We performed a review of the literature on mechanical bowel preparation and its consequences. There is no clear evidence that preoperative bowel cleansing reduces the septic complications of surgery and routine use of this procedure may increase anastomotic leaks and morbidity. Therefore, the results suggest that mechanical preparation is not required in elective colon and rectal surgery and that its use should be restricted to specific indications such as small nonpalpable tumors to aid their localization during laparoscopic procedures or to enable intraoperative colonoscopy. The role of mechanical bowel preparation in rectal surgery is not well defined and further trials with a larger number of patients are required.
    Cirugía Española 05/2007; 81(5):240-246. · 0.87 Impact Factor